COVID-19 is an emergent disease of aging

Santesmasses, Didac; Castro, José Pedro; Zenin, Aleksandr; Shindyapina, Anastasia V.; Gerashchenko, Maxim V.; Zhang, Bohan; Kerepesi, Csaba; Yim, Sun Hee; Федичев, П. О.; Gladyshev, Vadim N.

doi:10.1101/2020.04.15.20060095

Cited by 51 publications

(62 citation statements)

References 31 publications

(37 reference statements)

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“…Why the disease is particularly dangerous in older people is not yet known and poorly understood at the molecular level. It is clear, however, that age alone is by far the most significant risk factor for death due to COVID-19 [4,5]. Even prior to SARS-CoV-2, human coronaviruses and influenza viruses have been known to impact older people disproportionately [6], yet therapeutic strategies to protect this fraction of the population, with the exception of vaccines, have largely failed.…”

Section: Introductionmentioning

confidence: 99%

Why does COVID-19 disproportionately affect older people?

Mueller

McNamara

Sinclair

2020

Aging

827

740

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The severity and outcome of coronavirus disease 2019 (COVID-19) largely depends on a patient's age. Adults over 65 years of age represent 80% of hospitalizations and have a 23-fold greater risk of death than those under 65. In the clinic, COVID-19 patients most commonly present with fever, cough and dyspnea, and from there the disease can progress to acute respiratory distress syndrome, lung consolidation, cytokine release syndrome, endotheliitis, coagulopathy, multiple organ failure and death. Comorbidities such as cardiovascular disease, diabetes and obesity increase the chances of fatal disease, but they alone do not explain why age is an independent risk factor. Here, we present the molecular differences between young, middle-aged and older people that may explain why COVID-19 is a mild illness in some but life-threatening in others. We also discuss several biological age clocks that could be used in conjunction with genetic tests to identify both the mechanisms of the disease and individuals most at risk. Finally, based on these mechanisms, we discuss treatments that could increase the survival of older people, not simply by inhibiting the virus, but by restoring patients' ability to clear the infection and effectively regulate immune responses.

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Section: Introductionmentioning

confidence: 99%

Why does COVID-19 disproportionately affect older people?

Mueller

McNamara

Sinclair

2020

Aging

827

740

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“…36,37 Indeed, a group of researchers with significant experience in the of field of aging and biomarkers of biological age have released a preprint proposing that COVID-19 is an emergent disease of aging. 38 Previous studies of patients with the related SARS-CoV-1 and MERS (Middle East Respiratory Syndrome) coronaviruses also suggest that in addition to age, similar comorbidities to those that predispose to worse outcomes in COVID-19 played a role in mortality risk. [39][40][41][42] During the unrelated Influenza A (H1N1) pandemic, both obesity and hypertension were also identified as risk factors for poor outcome.…”

mentioning

confidence: 99%

Metabolic health and lifestyle medicine should be a cornerstone of future pandemic preparedness

Wood

Johannsson

2020

Lifestyle Medicine

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Metabolic health and lifestyle medicine should be a cornerstone of future pandemic preparedness The recent impact of SARS-CoV-2 and coronavirus disease 2019 (COVID-19) has shown major differences in infrastructure and approach across healthcare systems worldwide. One thing we can already be certain of is that governments and policy makers worldwide will place a greater focus on pandemic preparedness in the future. However, as well as ensuring that robust pipelines for rapid test, highly effective treatment or vaccine, and personal protective equipment (PPE) production are in place, we must address underlying resilience and susceptibility of our populations to infectious disease. Although the true spread and case fatality rate of SARS-CoV-2 may not be known for several months or even years, what is becoming increasingly clear is the significant degree to which underlying conditions associated with suboptimal metabolic health appear to be associated with poor outcomes in those with COVID-19. 1-4 Considering the nature of these underlying conditions such as obesity and hypertension, lifestylebased approaches are likely to be one of our best tools in order to address ongoing and future disease burden during pandemics. Based on the largest available studies at time of writing, the comorbidities particularly associated with hospitalization and poor outcome in patients with COVID-19 are age, obesity, hypertension, and diabetes. For instance, one study in New York City found that, of 5700 patients hospitalized with COVID-19, 57%, 42%, and 34% had hypertension, obesity, and diabetes, respectively. 1 Of 72 314 cases from the Chinese Center for Disease Control and Prevention, reported case fatality rate was elevated in those with comorbid conditions: at least 10% for cardiovascular diseases, 7% for diabetes, and 6% for hypertension. 2 Importantly, however, the diabetes diagnoses associated with increased risk have not routinely been separated by type (1 or 2) or duration, and this is a key area of future research. As outlined below, with metabolic derangement (eg, systemic insulin resistance) and hyperglycemia potentially underlying changes in the immune system seen in the comorbid conditions associated with worse COVID-19 outcome, it is possible that the well-controlled type 1 diabetic is not at increased risk. In studies of COVID-19 patients requiring invasive mechanical ventilation in Italy and New York City, the latter as a preprint at time of writing, both age and obesity were significant contributors to risk, with the mechanical disadvantage of ventilation in obese patients a potential contributor. 3,4 In the United Kingdom, the This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…This difference is very reasonable, given the different characteristics of the regions in Indonesia. [12][13][14][15][16][17][18] The calculation of CFR is particularly sensitive to the denominator: the greater the denominator, the smaller the CFR. The daily CFR figures can change according to the denominator, which in this case is the number of people who have been confirmed as positive COVID-19 based on real-time polymerase chain reaction (PCR) method.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Case Fatality Rate and Detection Ability in Indonesia

Sipahutar¹,

Eryando

2020

Kesmas: National Public Health Journal

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The world is currently experiencing a COVID-19 pandemic. More than 5 million people have been infected with COVID-19 and more than 300 thousand have died from this virus worldwide. In Indonesia, the number of infected people has reached more than twenty thousand people and more than one thousand people have died from this virus. During the COVID-19 pandemic, Case Fatality Rate was a very important measure for many people because death is very important to each person, including questions of when and how death will occur and whether there is any way to delay it. However, caution is needed in calculating and displaying CFR. This paper will present the uses and the weaknesses of CFR in the context of the COVID-19 pandemic in Indonesia.

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COVID-19 is an emergent disease of aging

Cited by 51 publications

References 31 publications

Why does COVID-19 disproportionately affect older people?

Why does COVID-19 disproportionately affect older people?

Metabolic health and lifestyle medicine should be a cornerstone of future pandemic preparedness

COVID-19 Case Fatality Rate and Detection Ability in Indonesia

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